Meningitis outbreak: Study will include Nashville victims

Apr. 10, 2013

Dr. Peter Pappas of the University of Alabama at Birmingham

Written by

Walter F. Roche Jr.

The Tennessean

Nashville-area victims of the nationwide fungal meningitis outbreak will be among the subjects of a federal study to determine the long-term effects of the deadly infections that have killed 53 across the country, including 14 in Tennessee.

“These infections are extremely rare. No one has ever seen anything quite like this,” said Dr. Peter Pappas of the University of Alabama at Birmingham. State and federal regulators say the outbreak was caused by fungus-tainted spinal steroids from a Massachusetts drug compounder.

“No one knows what is happening over time,” Pappas added.

The U.S. Centers for Disease Control and Prevention filed notice this week of its intent to negotiate a sole-source contract with the unit Pappas heads at the Alabama medical center.

The notice states that CDC officials concluded that the university’s Mycoses Study Group was the only group qualified to conduct the study.

“No other source for this service is known at this time,” the Monday notice states.

In a telephone interview, Pappas said the current plan is for the study to focus on Nashville and those victims treated at the Saint Thomas Outpatient Neurosurgical Center, along with other sites including a Michigan pain center where multiple victims have been reported.

“We’re committed to this for the long term,” said CDC medical epidemiologist Dr. Tom M. Chiller, who added that he wished the follow-up study could have been started even sooner.

He said the hope is to finalize the contract within the next few weeks after a comment period on the notice issued this week. The notice invites potential rivals to the Alabama-based group to petition for a competitive bidding process.

Chiller said the cost for one year of the study is expected to be more than $500,000, and it may be extended to a second year if funding can be found.

Since participation by victims will be voluntary, Chiller said the ultimate cost will depend on the number of victims ultimately enrolled.

“We want hundreds,” he said.

In addition to Michigan and Tennessee, Chiller said victims will be recruited from Indiana, New Jersey and Virginia.

Chiller said part of the urgency is that getting the study going could generate valuable treatment information which could then be passed along to physicians actively treating victims of the current outbreak.

“They need our help,” Chiller said. “We need to collect data as soon as possible. I wish we could have done it two months ago.”

Chiller said the expertise of Pappas’ group made it “the logical place to go” for the study. He said the CDC would remain as a partner in the project but did not have the expertise to lead the study effort.

Pappas said his group, which includes researchers from across the country and the globe, has been researching fungal infections since the late 1970s. Recent studies have focused on fungal infections contracted by transplant patients.

Pappas said the group already has been in contact with the Vanderbilt University Medical Center and Saint Thomas Hospital, where many of the local victims were treated.